Sidney Kimmel Medical College at Thomas Jefferson University.
Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University.
Am J Med Qual. 2022;37(5):388-395. doi: 10.1097/JMQ.0000000000000053. Epub 2022 Mar 17.
Individuals eligible for lung cancer screening (LCS) are at risk for atherosclerotic cardiovascular disease (ASCVD) due to smoking history. Coronary artery calcifications (CAC), a common incidental finding on low-dose CT (LDCT) for LCS, is a predictor of cardiovascular events. Despite findings of high ASCVD risk and CAC, a substantial proportion of LCS patients are not prescribed primary preventive statin therapy for ASCVD. We assessed the frequency of statin prescription in LCS patients with moderate levels of CAC. Among 259 individuals with moderate CAC, 95% had ASCVD risk ≥ 7.5%. Despite this, 27% of patients were statin-free prior to LDCT and 21.2% remained statin-free after LDCT showing moderate CAC. Illustratively, while a substantial proportion of LCS patients are statin-eligible, many lack a statin prescription, even after findings of CAC burden. CAC reporting should be standardized, and interdisciplinary communication should be optimized to ensure that LCS patients are placed on appropriate preventive therapy.
由于吸烟史，有资格进行肺癌筛查（LCS）的个体存在动脉粥样硬化性心血管疾病（ASCVD）的风险。冠状动脉钙化（CAC）是 LCS 中低剂量 CT（LDCT）的常见偶然发现，是心血管事件的预测指标。尽管发现 ASCVD 风险高且 CAC 水平高，但相当一部分 LCS 患者并未开具用于 ASCVD 的初级预防他汀类药物治疗。我们评估了 CAC 水平中度升高的 LCS 患者中他汀类药物处方的频率。在 259 名 CAC 中度升高的个体中，95%的个体 ASCVD 风险≥7.5%。尽管如此，在 LDCT 之前，27%的患者没有服用他汀类药物，而在 LDCT 显示 CAC 中度升高后，仍有 21.2%的患者没有服用他汀类药物。举例来说，尽管相当一部分 LCS 患者符合他汀类药物治疗条件，但许多患者缺乏他汀类药物处方，即使在 CAC 负担发现后也是如此。应标准化 CAC 报告，优化跨学科沟通，以确保将 LCS 患者置于适当的预防治疗中。
